Health care providers speak up for immigrants

Marlene Miranda, left, translates for United Neighborhood Dental Director Africa Jimerson as she examines the teeth of 8-year-old Kenny Calo as his mother, Alva Calo, watches at the Cayce Family Health Center in Nashville on Monday, June 10, 2013.(Photo: Steven S. Harman, The Tennessean)

Story Highlights

More hospitals are hiring translators to help non-English-speaking population

Vanderbilt University will offer Spanish class for health care professionals in the fall

Cultural barriers can be as obstructive to patient care as language differences

The woman, Marlene Miranda, works in the clinic as, in her words, "a CSR slash translator." The CSR stands for customer service representative, which describes part of her duties as a receptionist in the clinic's lobby. But she's also a go-to interpreter for patients and their doctors throughout the clinic.

In the past 20 years, interpreters like Miranda have grown in value in the Nashville area, especially in the health care community. To meet the language needs of the influx of immigrants into the area, health care providers have had to ratchet up their interpretation services.

"Everyone needs health care, no matter what language one speaks," she said.

The intermediate Spanish class is not a licensing class for interpreters but aims at improving interactions between health care workers and their Spanish-speaking patients. It will incorporate cultural lessons as well as language.

Dr. Adriana Bialostozky, a pediatrician at Vanderbilt University Medical Center, said cultural barriers can be just as obstructive as language differences between doctor and patient.

American patients are generally familiar with the process of a doctor's appointment and the idea of a referral. Patients who have recently emigrated, meanwhile, not only need help accessing the medical system — Bialostozky said bilingual receptionists are crucial — but then require assistance in navigating it once they are in.

Eighteen years ago, United Neighborhood Health Services, a network of 11 primary care clinics in the Nashville area, didn't have the personnel to treat Spanish speakers. But after the group hired a fluent nurse practitioner, Spanish speakers flooded in, said CEO Mary Bufwack.

"It became clear that we had tapped into a population that we hadn't been able to identify that was out there and in need," she said.

Today, about 10 percent of the clinic group's patients speak only Spanish. So the clinic employs 14 fluent employees — including Miranda — to meet with demand.

"When we look at our resumes, if someone speaks Spanish, we're going to look at their resume hard to see if they qualify for the position that is open," Bufwack said. "It's a skill at this point — a much-needed skill."

Other languages

Spanish isn't the only language in which translation help is needed. At Nashville's Siloam Family Health Center, the most common languages the staff works with are Spanish and Arabic. In 2012, however, the clinic's patient population spoke 69 languages.

To accommodate the diversity of its patients, Siloam — which provides care mainly with donated funds — uses a language phone line, provided to the clinic by a local university through an anonymous donation. The line is used through speaker phone during the patient's appointment.

"If someone is speaking say, Farsi, we pick up the language line, ask for Farsi and we are connected with an interpreter," said Deborah Barnett, director of communication at Siloam. "It's not as ideal as having someone in person interpret, but it really helps us communicate with our patients more effectively."

Miranda first began working as a health care interpreter for her mother's doctor appointments. She enjoyed it, so she put in an application. Thirteen years later, she said she still enjoys her work.

"When someone who doesn't speak the language comes and they are lost, you put yourself in their shoes," she said. "I did."